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Lamina depth and thickness correlate with glaucoma severity.

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Summary

Lamina cribrosa (LC) morphology, including depth and thickness, correlates with open-angle glaucoma (OAG) severity. These associations differ between normal-tension (NTG) and high-tension (HTG) OAG, suggesting distinct disease pathways.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Glaucoma Research

Background:

  • Open-angle glaucoma (OAG) is a leading cause of irreversible blindness.
  • Lamina cribrosa (LC) morphology is implicated in OAG pathogenesis.
  • Understanding LC structure-function relationships is crucial for diagnosing and managing glaucoma.

Purpose of the Study:

  • To investigate the correlation between lamina cribrosa (LC) morphology and glaucoma severity in primary open-angle glaucoma (OAG).
  • To differentiate these correlations in normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) subtypes.
  • To utilize enhanced depth imaging spectral-domain optical coherence tomography (SD-OCT) and Humphrey visual field testing (HVF).

Main Methods:

  • 166 OAG patients (66 NTG, 100 HTG) underwent SD-OCT imaging of the optic nerve head (ONH).
  • Horizontal B-scan images were analyzed to measure laminar depth (LD) and laminar thickness (LT) at the ONH center.
  • Multivariate linear regression and subgroup analyses correlated LD, LT, and intraocular pressure (IOP) with visual field mean deviation (MD).

Main Results:

  • Mean LD was 555.4 ± 142.3 μm, mean LT was 179.9 ± 49.7 μm, and mean MD was -5.7 ± 6.4 dB.
  • LD, LT, and IOP were significantly correlated with MD (P=0.007, P=0.037, P=0.004, respectively).
  • In NTG, only LD correlated with MD; in HTG, LT and IOP correlated with MD. Axial length and central corneal thickness showed no association.

Conclusions:

  • Glaucoma severity (HVF MD) correlates with LC morphology (LD, LT).
  • Increased LD and decreased LT are associated with greater glaucoma severity.
  • Distinct LD and LT associations in NTG and HTG suggest different pathogenic mechanisms for these OAG subtypes.